78例孤立性肺结节的诊疗分析

发布时间：2018-05-26 13:07

本文选题：孤立性肺结节 + 分叶征　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:在各种恶性肿瘤中肺癌的恶性程度是最高的,肺癌的早期诊断,早期治疗特别重要,通过对孤立性肺结节的分析,提高对早期肺癌的诊疗。方法:以吉林大学第二临床学院2015年1月至2016年12月期间胸外科收治的以肺孤立性结节影像学为特征改变的临床病例为研究对象,第一个方面为以分叶及毛刺征和血管集束征为指标统计分析所有患者经过术前应用病灶薄扫联合三维CT重建对于恶性结节的检出率。第二个方面为将患者性别、年龄、结节密度、结节大小、分叶及毛刺征和血管集束征纳入是否为恶性结节中。应用SPSS 19.0软件进行统计学处理,计数资料分析采用(34)2检验,p0.05为差异有统计学意义。分析不同病理性质SPN患者性别、年龄、结节密度、结节大小、分叶及毛刺征和血管集束征的差异用以指导对于对于孤立性肺结节良恶性的鉴别。将病变分为良性组和恶性组,对患者性别、年龄、结节密度、结节大小、分叶及毛刺征和血管集束征进行分析。通过(34)2检验,探讨不同病理性质SPN患者性别、年龄、结节密度、结节大小、有无分叶及毛刺征和有无血管集束征的差异。结果:共有78例患者纳入研究。78例患者中,男性22例,女性56例,年龄28~81岁,平均年龄为(56.34±8.63)岁,老年病人("g65岁)为32例。78例病例均行VATS下手术治疗,术后病理恶性结节62例,良性结节16例,恶性率为79.49%(62/78)。以血管集束征为依据,恶性结节的检出率达到66.67%(52/78)。以分叶及毛刺征为依据,恶性结节的检出率为71.79%(56/78),不同病理性质孤立性肺结节的分叶及毛刺征、血管集束征、密度、大小及其患者的性别、年龄之间的差异具有统计学意义,p值均小于0.05。结论:1、对于孤立性肺结节患者进行病灶薄扫联合三维CT重建,可以更加形象、直观地观察病灶的分叶及毛刺征和血管集束征,可以提高对恶性结节的检出率;2、患者的性别、年龄及SPN的大小,密度、血管集束征及分叶和毛刺征有助于SPN良恶性的鉴别。
[Abstract]:Objective: among all kinds of malignant tumors, the malignant degree of lung cancer is the highest, the early diagnosis and treatment of lung cancer is very important, through the analysis of solitary pulmonary nodules, the diagnosis and treatment of early lung cancer can be improved. Methods: the clinical cases of pulmonary solitary nodule, which were treated in thoracic surgery between January 2015 and December 2016 in Jilin University, were studied. The first aspect was to analyze the detectable rate of malignant nodules by thin scan and 3D CT reconstruction with lobular and burr sign and vascular cluster sign. The second aspect included sex, age, nodular density, nodule size, lobular and burr sign and vascular cluster sign. SPSS 19.0 software was used for statistical analysis. The differences of sex, age, nodular density, nodule size, lobular and burr sign and vascular cluster sign in SPN patients with different pathological characteristics were analyzed to guide the differential diagnosis of benign and malignant solitary pulmonary nodules. Patients were divided into benign group and malignant group. Sex, age, nodular density, nodule size, lobular and burr sign and vascular cluster sign were analyzed. The differences of sex, age, nodular density, nodule size, lobular and burr sign and vascular cluster sign in patients with different pathological properties of SPN were studied by means of the test. Results: a total of 78 patients were included in the study. There were 22 males and 56 females, with an average age of 56.34 卤8.63 years old. 32 cases ("g65 years old) of 32 cases) were treated with VATS. 62 cases of malignant nodules were treated with VATS. There were 16 cases of benign nodules, the malignant rate was 79.49%. On the basis of vascular cluster sign, the detection rate of malignant nodules was 66.67% or 52 / 78. On the basis of lobulation and burr sign, the detection rate of malignant nodules was 71.79% or 56 / 78%. The lobes and burr signs, vascular cluster sign, density, size and sex of patients with solitary pulmonary nodules of different pathological properties were observed. The difference between ages was statistically significant (P < 0.05). Conclusion in the case of solitary pulmonary nodule, thin scan combined with 3D CT reconstruction can be used to visualize the lobulation, burr sign and vascular cluster sign of the lesion, which can improve the detection rate of malignant nodules and the sex of the patients. Age, size and density of SPN, vascular bundle sign, lobulation and burr sign are helpful for differentiating benign and malignant SPN.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2;R563

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